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prior authorizations

CMS ready to roll with prior authorizations


BALTIMORE – CMS is moving forward with its plans to implement a prior authorization process for certain DME and stakeholders say it should make life easier for providers.

CMS publishes prior auth rule


BALTIMORE – CMS today issued a final rule that would establish a prior authorization process for certain durable medical equipment.

Managed care mess: Providers struggle with new reality of serving Medicaid recipients


YARMOUTH, Maine – The increasing number of states turning to managed care to run their Medicaid programs is creating a logistical nightmare for providers.

‘Pressure’ is on to expand prior auths


YARMOUTH, Maine – CMS recently extended a demo requiring prior authorizations for certain power mobility devices, and providers say it may be time to consider other product categories, too.

Blackburn’s bill seeks to expand prior authorizations


WASHINGTON – Rep. Marsha Blackburn, R-Tenn., introduced a bill last week that would require prior authorizations for high-dollar DME.

CMS schedules special forum on PMD demo


WASHINGTON – CMS will host a Special Open Door Forum on Aug. 12 to allow DMEPOS suppliers and others to ask questions about the expanding PMD demon.

CMS announces Oct. 1 start date for PMD demo expansion


WASHINGTON – CMS will expand its PMD demonstration to 12 additional states on Oct. 1, the agency announced in a final rule published this week.

Stakeholders say prior auths need to be timely, efficient


WASHINGTON – Although industry stakeholders are still combing through a plan to implement a prior authorization (PA) process for certain DME, they think it could be a good thing—with a few caveats.

New proposal digs deeper into wheelchair codes


WASHINGTON – Certain wheelchair codes not included in the current PMD demo project could be included in a new prior authorization program recently proposed by CMS.

Industry ‘ready’ for prior auths


WASHINGTON – Industry stakeholders support CMS’s plans to expand the PMD demo—with a few tweaks.  

“I’m all for it,” said Peggy Walker, billing specialist at VGM. “I’m ready for more prior auths.”